Japan has some of the best medicine, but all is not well

By Amelia Lester

August 25, 2018 — 12.06am

Illustration: Simon Letch.

The best thing about going to the dentist in a foreign country is they don't bother telling you to floss. I've long wondered: do dentists know they've lost the flossing battle? Sure, some of us floss some of the time, usually for a week after a visit, at least. But asking, "How often do you floss?" as dentists tend to do, strikes me as such a sweetly optimistic way of seeing the world.

The second-best thing about going to the dentist in a foreign country is they don't try to carry on a conversation while filling your mouth with heavy metals and drills. I had time to contemplate these differences while in the dentist's chair in Japan. There'd been a disagreement, you see, with one of those crispy fruit-and-seed crackers. The cracker had won, which is how I came to be reclining in a fleece blanket, with an equally soft fabric draped across my eyes, as a skilled pro worked silently and efficiently to undo my recent life choices.

The only thing anyone said to me on the entire visit was, "You have nice eyes," which came from a technician charged with taking a series of excruciatingly unflattering photos of my mouth. (All dentist trips in Japan begin with the photo-taking.) That was nice to hear, because the gist of her prolonged conversation with the dentist about my teeth, although conducted in another language, seemed less positive.

But while the dentist is happy to coddle, going to the doctor in Japan involves some DIY. You take your own blood pressure at the start of the visit, and weigh yourself, too. The eye exam involves a page-long list of instructions. There's no fibbing about your results, though – these machines spit out receipts that you must then present to the doctor. It's like handing in your homework.

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I've heard intimidating things about childbirth here: epidurals are unheard-of, and women labour upright, in a chair. But for the most part, medical procedures seem to progress in much the same way as they do elsewhere, except there's a designated spot for your shoes in the exam room. This is unsurprising. Everywhere you go in Japan there's a designated spot for your shoes.

You will never spend so much time considering the state of your toenails as you do in Japan.

My limited experience with the Japanese medical profession has been positive. Recently, though, there was a shocking revelation about one of the country's most prestigious medical schools.

Tokyo Medical University, it was reported, deliberately altered entrance exam scores to restrict the number of women students matriculating. This practice began in 2006, or perhaps even earlier, according to an internal investigation. Male students were given 20 extra points on their entrance exam. Studies show the share of female doctors who have passed this national exam has plateaued at 30 per cent for more than 20 years. There's a fear that other medical schools have been engaging in the same discriminatory practice.

I was interested to find out what the situation is for women within Australia's medical workforce. Although gender parity was achieved in our medical schools in 2000, their participation is still skewed towards certain specialties. Women make up more than half the nation's paediatricians and almost half the obstetricians, yet remain under-represented in surgery. In Sweden, by contrast – you knew I was going to bring up Sweden – male and female medical students show remarkably similar preferences.

As with all things health-related, it's a matter of finding a balance.